Summary of this article
Add newborn to health insurance from birth for full, no-limit coverage.
Inform insurer within 30–91 days to avoid waiting periods or exclusions.
Family floater plans offer cost-effective, comprehensive protection.
Early enrolment ensures coverage for neonatal or congenital conditions.
Once you welcome a baby to the world, it is important to upgrade your health insurance. The policy should allow for a newborn baby addition from the time of birth for the full sum insured without any sub-limits and without any waiting period. This will ensure that the baby is covered for neonatal, genetic, or congenital conditions from birth itself.
Says Sarita Joshi, head of health and life insurance, Probus Insurance Broker: “The best time for parents to inform their insurer is as soon as the baby is born. Most insurers have a specific time window, usually up to 91 days, for adding a newborn to the existing policy; however, this completely depends on the policy the parent has opted for. Early intimation of the newborn ensures uninterrupted coverage right from the beginning, especially in case of birth complications or sudden medical needs, and at the same time avoids the need for fresh medical underwriting."
Inform Insurer As Soon As Possible
Parents should inform the insurer as soon as possible, or usually within 30 days of the baby’s birth, to cover under the health insurance policy. They should also upgrade the sum insured to at least Rs 15 lakh to Rs 25 lakh to keep up with rising medical costs.
“If the policyholder/parents miss this window, the insurer may treat the newborn as a new enrolment. They might then have to fill out a separate application and possibly serve the waiting periods or some exclusions,” says Siddharth Singhal, business head of health insurance, Policybazaar.com.
Under retail policies, some companies allow the immediate addition of babies. However, some other insurers have imposed a 90-day period for inclusion of newborn babies, which will have the effect of imposing a waiting period and excluding any neonatal or genetic, or internal congenital conditions.
Says Hari Radhakrishnan, expert, Insurance Brokers Association of India (IBAI): “Some insurers allow the addition of a baby where maternity is covered under the base policy covering the parents. However, according to the Insurance Regulatory Development Authority (Irda) circular dated 12.10.2022, coverage should be given from birth for newborn babies under all health insurance policies for internal congenital conditions."
The policy should allow for newborn baby addition from the time of birth for the full sum insured without any sub-limits and without any waiting period. This will ensure that the baby is covered for neonatal, genetic, or congenital conditions from birth itself.
When A Family Floater Plan Is Ideal
A family floater plan is ideal and cost-effective only if the parents are relatively young and no older member of the family has a high-risk disease. “On the other hand, buying a standalone child health insurance policy is ideal when the parents are keen on child-specific benefits like vaccination cover, congenital disease cover, or critical illness cover for children, etc,” says Sinhgal.
A newborn cannot be covered under a standalone health policy, as such plans are typically applicable only to children above 18 years of age. "Therefore, parents can opt to add the baby to their existing family floater plan after 91 days of birth or as per the waiting period defined by their insurer. When comparing options, parents should look at factors like premium, coverage benefits, sum insured, renewal flexibility, and ease of management. A family floater plan is usually more economical and convenient, ensuring comprehensive coverage for the entire family under a single policy, says Joshi.
Early enrolment helps parents avoid or minimise waiting periods, as for most diseases, the waiting period is 30 days. For listed ailments, including congenital or developmental conditions, the waiting period might range between one and four years. It is important to check for the same with your insurer.
